Leadership in Healthcare – Changes Over the Past 10 Years

leadership in healthcare

I can remember being a new nurse; our nurse-to-patient were by no means “good”, but could be considered tolerable.  On night shift, we even had time to chat over coffee, every now and then!

Eventually, things changed.  As an LPN and a newer nurse, some of the changes that CMS made didn’t make much sense to me, but I certainly understood the two extra patients that were being assigned to each team.  I regularly worked overtime to finish my work – then began to work overtime because our nurses became burned out or sick, and then started leaving the floor.

Then I became burned out and left the floor.

My story is nothing unique.  I’m sure that many of you have a similar story.  

So what is going on in healthcare?  

Healthcare costs are rising; there are many reasons for the rise in costs, such as changes that CMS has made as well as an increase in the average age and the subsequent worsening health of our patients.  Rising costs have led to changes like increased staff to patient ratios, worldwide drug shortages and the need to implement cost saving measures like restructuring the hospital workforce – and many are changes that professionals on the frontline don’t necessarily agree with.

One big change that we all notice, regardless of whether we are working in healthcare or we are a consumer of healthcare, is that private physician practices are being acquired by hospital systems or private equity firms, a measure meant to improve outcomes for both the hospital and the practice through partnership and network referrals.  A study from the Annals of Internal Medicine indicated that in 2017, private equity firms acquired 102 private practices. According to consulting group Bain & Company, “Healthcare private equity deals, including providers, rose 50% to $63.1 billion, topping 2017’s level of $42.6 billion, and deal count rose to 316 in 2018 from 265 in 2017.”

Our present state of healthcare spends a great deal of time working towards preventive care; and yet we’re still spending billions of dollars treating acute episodes of chronic conditions.  The CDC reports that many of the chronic conditions that we are treating could be avoided through preventive services that are currently available – impacting upwards of 75 percent of our healthcare spending. In fact, they note that over 100,000 lives could be saved if everyone in our country actually received the recommended preventive measures.

Present State of Leadership

Healthcare leadership is in an interesting state as we move into the next decade.  We’re currently spending much of our time reviewing quality metrics, such as HCAHPS and Press Ganey scores.  We’re modeling our healthcare systems based on these scores, as well as measures set forth by insurance and CMS.

Another current trend is the lack of leadership from the top down.  The current hospital CEO turnover rate was at 18% in 2015.  According to research, once a CEO leaves, it is likely that the top three executives will also follow suit – the chief operating officer, the chief financial officer, and the chief nursing officer.

Continuing advances in technology, make it a great time for medicine – but frontline staff are getting burned out but the constant need to adapt and change while our leadership teams, the people that we look to for guidance and education are getting more and more sparse.  

What can we expect in the future?

Robotics are in operating rooms.  Families are getting pinged with updates while loved ones are lying in a cardiac catheterization lab.  Continuous glucose monitors are reading glucose levels in real-time, eliminating the need for finger sticks.  We are in the technology age – and it doesn’t seem to be slowing down any time soon.

Healthcare leadership needs to be ready for these changes.

An interesting concept, according to American Association of Physician Leadership, “…  connected devices track everything from blood sugar and heart health to compliance. In the future, it’s likely they will monitor virtually all vital signs and gauge activity and exercise in a comprehensive and holistic manner. Connected systems with microsensors will monitor and control the release of medicines into the body. All of this could aid doctors in doing what matters most: improving patient health.”

The leader’s responsibility?  Figuring out how to execute this improvement in patient health.  One option could be virtual visits, which may improve patient and provider satisfaction, as well as improve relationship, reduce burnout, and enhance patient outcomes.

A recent study conducted by Stanford and the Harris Poll found that physicians spend half of their working days using the electronic health record; their response to this survey was to create a new leadership role – chief wellness officer, who could work on issues like improving documentation that may then lessen burnout.

And what to our patients expect?

Well, for starters, as technology is improving, they will likely want to have continued and improved access to their medical records online, as well as communication with their providers electronically, perhaps quicker than the current standard.  They will want to have a visit with their provider on their terms – when they want it and where they want it – virtually, if possible. They will also want continued advances in technology that benefit them.

They will also want a leadership team that continues to work towards these goals.

The Bottom Line…

Healthcare has rapidly changed over the past 10 years.  There have been many advancements in technology that will continue to improve our ability to care for our patients.  Our plea to our healthcare leaders is that over the next 10 years, we continue to grow and accommodate our patients wishes while also caring for our frontline staff.

Resources

Future of Healthcare Leadership. (n.d.). Retrieved October 9, 2019, from https://www.studergroup.com/future-of-healthcare-leadership

Greengard, S. (2019, March 29). A look into the future of health care leadership. Retrieved October 9, 2019, from https://www.physicianleaders.org/news/future-of-health-care-leadership

Henderson, R. (n.d.). Growing pressures facing healthcare leadership. Retrieved October 9, 2019, from https://www.amnhealthcare.com/blog/2016-healthcare-trends-for-execs/

Landi, H. (2019, May 2). Healthcare leaders look at the past, present and future of consolidation. Retrieved October 8, 2019, from https://www.fiercehealthcare.com/practices/healthcare-leaders-look-at-past-present-and-future-consolidation

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